全程连续性助产干预在妊娠期肝内胆汁淤积症产妇中的应用及对妊娠结局、新生儿Apgar评分的影响

Application of whole-process continuous midwifery intervention in pregnant women with intrahepatic cholestasis of pregnancy and the effect on pregnancy outcome and neonatal Apgar score

目的研究全程连续性助产干预在妊娠期肝内胆汁淤积症产妇中的应用及对妊娠结局、新生儿Apgar评分的影响。方法选取2016年5月-2017年7月在佛山市妇幼保健院诊治的120例妊娠期肝内胆汁淤积症患者作为研究对象,根据随机数表法分为对照组和研究组,每组各60例。对照组患者采用常规护理干预,研究组患者在对照组常规护理基础上采用全程连续性助产干预措施。比较两组新生儿Apgar评分、患者心理健康水平及妊娠结局情况。结果研究组新生儿出生后1 min、10 min Apgar评分均高于对照组(P<0.05);干预措施实施后两组患者SAS、SDS评分均低于干预前,且研究组低于对照组(P<0.05);研究组胎儿窘迫、胎儿缺氧及患者产后出血发生率(1.7%)均低于对照组(18.4%)(P<0.05)。结论全程连续性助产干预应用于妊娠期肝内胆汁淤积症产妇中效果显著,能有效提高患者心理健康水平,改善妊娠结局,增强围产儿身体状况。

Objective To research the application of whole-process continuous midwifery intervention in pregnant women with intrahepatic cholestasis of pregnancy（ ICP） and the effect on pregnancy outcome and neonatal Apgar score. Methods From May 2016 to July2017,120 patients with ICP diagnosed and treated in Foshan Maternal and Child Health Care Hospital were selected and divided into control group and study group,60 patients in each group. The patients in control group were treated by routine nursing intervention,and the patients in study group were treated by whole-process continuous midwifery intervention based on routine nursing intervention. Neonatal Apgar scores,psychological health levels,and pregnancy outcomes in the two groups were compared. Results One-minute neonatal Apgar score and 10-minute neonatal Apgar score in study group were statistically significantly higher than those in control group（ P〈0. 05）. After intervention,SAS and SDS scores in the two groups were statistically significantly lower than those before intervention（ P〈0. 05）. SAS and SDS scores after intervention in study group were statistically significantly lower than those in control group（ P〈0. 05）. The incidence rate of fetal distress,fetal hypoxia,and postpartum hemorrhage in study group was 1. 7%,which was statistically significantly lower than that in control group（ 18. 4%）（ P〈0. 05）. Conclusion The effect of whole-process continuous midwifery intervention in pregnant women with ICP is significant,which can effectively improve psychological health and pregnancy outcome,and enhance physical condition of perinatal infants.